Body Mass Composition in asthmatics according to inflammatory phenotypes (SAMBA trial)

Asthmatics often complain from dyspnea and exercise limitation. We wanted to evaluate body mass composition and exercise capacity of asthmatics poorly controlled despite treatment with inhaled therapies. <b>Methods:</b> Since September 2020, 14 healthy subjects and 33 uncontrolled asthmatics were recruited from the Asthma Clinic of CHU of Liege. Patients underwent detailed investigations including induced sputum, exercise testing and Dual-Energy X-ray Absorptiometry (DEXA) scans allowing the assessment of body composition in 3 minutes (NHANES calibration). DEXA determines the overall body fat mass and fat-free mass including specific body segments such as arms, trunk, waist, hips and legs. The study was approved by Ethics Committee (2019/362). <b>Results:</b> Mean age of asthmatics was 45yrs+/−12, 51% were females, 3% active smoker, FEV1 84% pred. Compared to healthy subjects, asthmatics had a higher BMI (29+/−5kg/m2 vs 22, p&lt;0.0001) and Fat Mass Index (FMI; 11.4 vs 5.9kg/m2, p=0.0005), lower lean mass (61% vs 71%, p=0.0012) and more android fat distribution (p&lt;0.0001). Asthmatics had a VO2 max of 20ml/min/kg. Eosinophilic asthma (sputum eos &gt;3%) had a trend (p&lt;0.10) to have a higher proportion of lean mass (65% vs 60%), lower FMI (9% vs 12%) and had a higher VO2 max (23.3 vs 19.5ml/min/kg) as compared to non-eosinophilic (n=21). <b>Conclusion:</b> Our study confirms that uncontrolled asthmatics despite good adherence to inhaled therapies are overweight and have decreased exercise capacity. Aerobic training could have a strong beneficial impact on asthma control and on body composition in these asthmatics. Whether asthma inflammatory phenotypes exhibit different body&nbsp;composition has to be confirmed&nbsp;in a larger study.